bulimia

Bulimia is one of the most frightening addicting diseases. Who could possibly think that throwing your fingers down your throat could be such a satisfying feeling.

I remember a year or so ago eating at Pizzeria Uno ((sorry to get too terribly person but I think a lot of people with that problem relate)), I was getting nervous because time was ticking by and I still had food in my stomach, it had to have been the most horrify terrifying feeling. I had had an eating disorder for about a year and I was used to eating waiting 15 minutes or so and then getting rid of it -- that's what I called it -- get rid of -- as casual as throwing it away in the trash. No big deal.

So on this night at Uno's I went into the bathroom, did the usual routine, made sure no one was in there, kneeled on the floor and stuck my fingers down my throat. By this time I had learned to throw-up silently, as not to arouse suspicion or concern. So I'm kneeling on the floor in this tiny little bathroom stall, vomiting pizza skins and salad - eyeliner streaming down my face from the force of my retching.

I wiped my fingers off - flushed the toilet, went over to the sink to rinse my mouth, pop some altoids in, fix my make-up and reddened, watering eyes, wiped the vomit out of the front strands of my hair - smiled at myself, thinking it was good to have gotten rid of all that food - I'd lost 40 pounds in three months - due to this, anorexia and excessive exercise.

And then I started to cry - thin and hysterical - crying and hopeless because even when I wanted to I couldn't stop - even when I said that would be the last time - even when my closest friends implored me to get help - I didn't listen. And that is why I cried. My chest hurt, my stomach hurt and I felt like I was going to die.

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bulimia: a syndrome of episodic binge eating of massive amounts of foodstuffs with subsequent purging through self-induced vomiting and sometimes laxative or enema use. Obesity is not usually seen in bulemics who may be normal to slightly overweight. This syndrome may alternate with anorexia nervosa or occur in combination as in bulimarexia. These eating disorder syndromes may be manifestations of hypophilia in that they tend to affect sexuoeroticism by reversing the effects of puberty.

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Bulimia is a hell of a lot easier than anorexia. You get to be thin, and you get to eat. It's extremely tempting to dismiss bulimics: chances are they'll maintain a normal weight, due to eating 'normally' in public and using inefficient methods of purging, such as laxative or diuretic abuse. This is a mistake. Bulimia is extremely serious, self-perpetuating and potentially fatal.

Use your fingers to induce vomiting, NOT an emetic such as Ipecac. Using Ipecac to regurgitatefood is like using a chainsaw to file your nails. It is given in hospital when the patient has swallowed something extremely toxic and must puke or die. Someone on the bus mailing list described the attitude as "we'll use it now and worry about what it rips loose later". Ipecac itself is toxic, and if for some reason you don't puke you will poison yourself. In many states, you are meant to call poison control before you administer it, not wait until something goes wrong. (The divine dustfromamoth asked me to add that Ipecac can kill on first usage, and using it only a few times can do major damage to your heart.)

And, in light of the above, for god's sake keep your nails short! Hitting the gag spot with long, jagged nails will hurt.

Laxative or diuretic abuse is completely pointless. Calories are absorbed a long time before the food hits the colon/bladder. More to the point, they are addictive, can kill you and, in the case of laxatives, can seriously fuck up your intestines with long-term use.

And above all, SEE A FUCKING DOCTOR!
Bulimia is not good. It's actually more immediately dangerous than anorexia, if only because you are harming yourself in more ways than just starvation. And as Marya Hornbacher says, "The minute you stick your fingers down your throat you know something's wrong." Bulimia does not have the capacity for denial that anorexia does.
You're sick.
See a fucking doctor.

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Most of you, if you see me, wouldn't immediately suspect me of being bulimic. I'm a tall, reasonably healthy looking male who enjoys reading, writing, and playing basketball on the weekends. I often wear loose clothing that, because of my broad shoulders and a still-lingering bit of fat from my childhood, gives the impression of a healthy weight, if not a bit on the heavy side.

My darkest secret is that I regurgitate almost every piece of food that I consume. I can often hold it down for as long as 45 minutes, but food will simply not stay in my stomach for whatever reason.

I recently gave an interview on the topic to a local newspaper that was running a series of reports to put a "surprising" face on medical disorders. I recorded the interview myself and what follows is a noded transcription of the interview with a few additions for clarification contained within (parentheses). I also trimmed away some general "getting to know you" stuff that's not very relevant to bulimia; it merely casts me as a relatively normal twentysomething male.

So, tell me your story.
I was born in a small town and I was very overweight as a child. When I went away to college, I became very concerned about my body to the point that I began to avoid eating, almost entering a state of anorexia. After this experience, I discovered that whenever I would eat, almost every time I would simply regurgitate my food. You might want to also note that even though I am bulimic, I still have some of the fat that I developed from my childhood. Bulimia is purely a psychological condition that, over time, can develop physical symptoms; it has little to do directly with weight loss.

How long has this been going on?
I have been doing this consistently since 1996 and pretty much constantly since mid-1998 (coincidentally near a time where I made a rather poor and childish suicide attempt, which I will write about in the future and the immediate aftermath of which I write about here; I didn't reveal that during the interview).

Have you seen a doctor about your condition?
I have seen several physicians and a pair of psychologists about it. My regular physician believes that my metabolism and digestive pathways have adapted to this condition, since it has been ongoing for eight years, and that I now absorb some elements of the food I eat quickly and then reject the rest in much the same way that many people reject toxins in their stomach.

So, you do get some nutrition when you consume food, but before you regurgitate it?
Yes. Although my physician hasn't confirmed this, I also believe that I absorb the fats and carbohydrates from food very quickly, thus the fact that outwardly I don't exactly look like the stereotype victim of bulimia.

How do you eat, then? I mean... how do you get your nutrition?
I can consume water without a problem, and that is my savior. I grind up vitamins into the water (and often add fiber in the form of Metamucil in small doses) and I have no problem drinking it and keeping it down.

How do you handle this socially?
I generally don't talk about it at all; I only mention it for educational reasons, and often I'll use myself in the third person when talking about it to others.

I mean, in social situations. How do you handle bulimia when you dine with friends?
I'll just eat my meal normally, then excuse myself to the restroom when there is a lull in the conversation. Quite often at restaurants, I am able to make a bathroom stop before we leave the restaurant; going out to eat makes "hiding" the condition easier.

Do you enjoy eating?
Very much so. The taste of food has always been appealing to me. I am quite a big fan of crème brûlée, for example.

I have a list of standard symptoms of bulimia. Let's go through these one by one, and you can offer any comments you would like on each of the symptoms.
Self-induced regurgitation?
At one time my regurgitation was self-induced. After a long enough period of time, however, it seems as though my body has simply adapted to rejecting food. I sometimes wonder if my GI tract simply won't accept food any more.

Eating binges?
I have a tendency to "pig out" when I eat my favorite foods. I've been asked about these symptoms a lot at various doctor's offices, and I have never really understood what is meant by eating binges. I don't continually cram food into myself in order to encourage vomiting, if that's what you would like to know.

A sense of guilt?
I feel very guilty about wasting food, which I feel like I do a lot. I usually get hit with a pretty big wave of guilt and sadness after I regurgitate, but after an hour or so, it passes.

Do you ever feel weak or dehydrated?
If I exercise strenuously, I do, but nothing abnormal. I took a few physical stress tests with my physician and he said that I am pretty normal in terms of physical performance, if not a bit above average.

Have you ever used laxatives or water pills?
No. At this point, I don't know what would come out. I don't know if this is too much information for your article, but I have roughly one bowel movement a week, and it is extremely soft, but not watery (with this comment, my interviewer kind of laughed, shook her head, and said "All right," but she wrote it down anyway).

Have you ever exercised to extreme exhaustion with the goal of losing weight?
When I first got bulimia, I did that several times, but I now have some issues with my lower back which prevent me from playing for too long at a stretch, so the answer is no. Now, would I if it didn't give me a lot of pain? I don't know... I really can't say.

Does your weight fluctuate a lot?
Not really. Over about a week, my weight might drift down a couple of pounds, but at the end of the week, I usually eat a ... less than healthy meal or two and after that my weight is back where I started.

So, you don't really push yourself to be thin? You're OK at this point with your body image?
I would love to be thinner than I am now, but I don't see how that can really be accomplished. I am sometimes sad when I look in the mirror that I don't have a body like Ricky Martin or something like that, and I know that if I had a way of doing it I would try, but I simply don't. It does bother me quite a bit.

Do you consider your condition to be life threatening?
That's a bit of a trick question. For me, I don't think that it is, given my body's metabolism and the ways in which I've adapted to it. For many others, it is unquestionably a dangerous condition. Eating disorders are bad for anyone who has them; I am very lucky that I am able to live through this.

Umm... that about does it. Do you have any words of advice to anyone with bulimia or any eating disorder?
If you're suffering from an eating disorder, please, go talk to your doctor, or at least talk to a friend. More important, if you have a friend or a loved one who you think might have an eating disorder, talk to that person. Show that person love and compassion and try to help them to help themselves.

I gave this interview to a newspaper in a small city in Iowa in the summer of 2002. I watched the paper for quite a while to see if an article on bulimia or any other eating disorder appeared, but it apparently went unpublished, which is unfortunate.

Bulimia is a real thing. It is a dangerous, scary, frightening thing. For most people it is a life-threatening thing. Please, if you have a friend that you think may have bulimia or another eating disorder, talk to them about it. Tell them how much you care about them and love them, and how you want to help them. Love is the most important part of the battle against eating disorders.

Update, June 2005: I have had much success in recent months thanks to eating very, very slowly and eating tiny portions compared to what I was eating before. I can generally hold down most foods provided I don't follow a meal with strenuous activity. Thanks to many of you for your concern.